Assessment of radiation risks of morbidity and mortality for the main classes of non-cancer diseases among participants in the consequences of the Chernobyl accident

«Radiation and Risk», 2026, vol. 35, No. 2, pp.92-109

DOI: 10.21870/0131-3878-2026-35-2-92-109

Authors

Chekin S.Yu. – Head of Lab. Contacts: 4 Korolyov str., Obninsk, Kaluga region, Russia, 249035; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. .
Maksioutov M.A. – Head of Dep., C. Sc., Tech.
Tumanov K.А. – Head of Lab., C. Sc., Biol.
Karpenko S.V. – Engineer
Korelo A.M. – Sen. Researcher
Pryakhin E.A. – Researcher
Lashkova O.E. – Researcher. A. Tsyb MRRC.
A. Tsyb MRRC, Obninsk

Abstract

The main long-term effect of ionizing radiation in low doses on human health is currently considered to be an increase in the incidence of malignant neoplasms among exposed individuals. However, the International Commission on Radiological Protection (ICRP) in 2007 noted the "potential importance of monitoring the incidence of non-cancer diseases" and stated that there was insufficient evidence of their radiation risks at radiation doses of less than 0.2 Gy. In previous studies of Russian partici-pants in the liquidation of the consequences of the Chernobyl accident (liquidators), registered and observed since 1986 in the system of the National Radiation and Epidemiological Registry (NRER), it was shown that the radiation risks of non-cancer diseases can make a significant contribution to the overall radiation damage to human health, comparable with damage from malignant neoplasms. Therefore, their study is important from the point of view of radiation protection. The purpose of this work is to update the results of the assessment of radiation risks of non-cancer diseases of liquidators obtained during the period of NRER observations in 1988-2019, taking into account new data accumulated by the end of 2024. Radiation risk estimates were obtained within the framework of a linear threshold-free risk model and in the form of nonparametric estimates of relative risk (RR) in dose groups. The most important diseases in further calculations of possible radiation damage to liquidators are diseases of the circulatory system (I00-I99) and diseases of the digestive system (K00-K93), since radiation mortality risks have been identified for these diseases with coefficients ERR/Gy=0.49 at 95% CI (0.28; 0.71) and ERR/Gy=0.73 at 95% CI (0.20; 1.34), respectively. These estimates are 4 and 7 times higher than the estimates obtained earlier in the Japanese cohort of people who sur-vived the atomic bombings in 1945, and correspond in magnitude to the ERR/Gy estimates for solid malignant neoplasms recommended by the ICRP to substantiate the norms and rules of radiation protection. At radiation doses of less than 0.150 Gy, the estimated linear non-threshold risk model of radiation mortality risks from diseases of the circulatory system is conservative, i.e. leads to overes-timated estimates of radiation risks. The effect of multimorbidity on the assessment of radiation risks of non-cancer diseases may be significant and requires further investigation.

Key words
Chernobyl accident, liquidators, external radiation, absorbed dose, radiation risk, excessive relative risk, relative risk, non-cancer diseases, diseases of the circulatory system, diseases of the digestive system, public health.

References

1. Preston D.L., Ron E., Tokuoka S., Funamoto S., Nishi N., Soda M., Mabuchi K., Kodama K. Solid cancer incidence in atomic bomb survivors: 1958-1998. Radiat. Res., 2007, vol. 168, no. 1, pp. 1-64.

2. Jablon S., Ishida M., Beebe G.W. Studies of the mortality of A-bomb survivors. 2. Mortality in selections I and II, 1950-1959. Radiat. Res., 1964, vol. 21, no. 3, pp. 423-445.

3. Belsky J.L., Tachikawa K., Jablon S. The health of atomic bomb survivors: a decade of examinations in a fixed population. Yale J. Biol. Med., 1973, vol. 46, no. 4, pp. 284-296.

4. Shimizu Y., Kato H., Schull W. J., Hoel D.G. Studies of the mortality of A-bomb survivors. 9. Mortality, 1950-1985: Part 3. Noncancer mortality based on the revised doses (DS86). Radiat. Res., 1992, vol. 130, no. 2, pp. 249-266.

5. United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR). Effects of ionizing radi-ation. UNSCEAR 2006 Report to the General Assembly with Scientific Annexes. Vol. II. New York, United Nations, 2009. 338 p. Available at: https://www.unscear.org/docs/publications/2006/ UNSCEAR_2006_Report_Vol.II.pdf (Accessed 12.05.2026).

6. ICRP, 2007. The 2007 Recommendations of the International Commission on Radiological Protection. ICRP Publication 103. Ann. ICRP, 2007, vol. 37, no. 2-4, pp. 1-332.

7. Ivanov V.K., Maksioutov M.A., Tumanov K.A., Chekin S.Yu., Vlasov O.K., Gorski A.I., Korelo A.M., Shchukina N.V., Zelenskaya N.S., Lashkova O.E., Ivanov S.A., Kaprin A.D. From AUDR to NRER: on the 40th anniversary of the creation of the state information system for monitoring the radiological consequences of the Chernobyl accident. Radiatsiya i risk – Radiation and Risk, 2026, vol. 35, no. 2, pp. 7-38. (In Russian).

8. Pitkevich V.A., Ivanov V.K., Tsyb A.F., Maksyutov M.A., Matyash V.A., Shchukina N.V. Dosimetric data of the All-Russia Medical and Dosimetric State Registry for emergency workers. Radiatsiya i risk – Radiation and Risk, 1995, special issue 2, pp. 3-44. (In Russian).

9. United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR). Effects of ionizing radi-ation. UNSCEAR 2006 Report to the General Assembly with Scientific Annexes. Vol. I. New York, United Nations, 2008. 392 p. Available at: https://www.unscear.org/docs/publications/2006/ UNSCEAR_2006_Report_Vol.I.pdf (Accessed 12.05.2026).

10. Ivanov V.K., Maksioutov M.A., Chekin S.Yu., Kruglova Z.G., Petrov A.V., Tsyb A.F. Radiation-epidemio-logical analysis of incidence of non-cancer diseases among the Chernobyl liquidators. Health Phys., 2000, vol. 78, no. 5, pp. 495-501.

11. Ivanov V.K., Maksioutov M.A., Chekin S.Yu., Petrov A.V., Biryukov A.P., Kruglova Z.G., Matyash V.A., Tsyb A.F., Manton K.G., Kravchenko J.S. The risk of radiation-induced cerebrovascular disease in Chernobyl emergency workers. Health Phys., 2006, vol. 90, no. 3, pp. 199-207.

12. Ivanov V.K., Chekin S.Yu., Kashcheev V.V., Maksioutov M.A., Tumanov K.A., Tsyb A.F. Mortality of the Chernobyl emergency workers: dose dependences and groups of the potential risk. Radiatsionnaya biologiya. Radioekologiya – Radiation Biology. Radioekology, 2011, vol. 51, no. 1, pp. 41-48. (In Russian).

13. Ivanov V.K., Kashcheev V.V., Chekin S.Yu., Maksioutov M.A., Tumanov K.A., Kochergina E.V., Shchukina N.V., Tsyb A.F. Morbidity and mortality among emergency workers of the Chernobyl accident: assessment of radiation risks for the follow-up period of 1992-2008. Radiatsionnaya gigiena – Radiation Hygiene, 2011, vol. 4, no. 2, pp. 40-49. (In Russian).

14. Little M.P., Azizova T.V., Bazyka D., Bouffler S.D., Cardis E., Chekin S., Chumak V.V., Cucinotta F.A., Vathaire de F., Hall P., Harrison J.D., Hildebrandt G., Ivanov V., Kashcheev V.V., Klymenko S.V., Kreu-zer M., Laurent O., Ozasa K., Schneider T., Tapio S., Taylor A.M., Tzoulaki I., Vandoolaeghe W.L., Wake-ford R., Zablotska L.B., Zhang W., Lipshultz S.E. Systematic review and meta-analysis of circulatory disease from exposure to low-level ionizing radiation and estimates of potential population mortality risks. Environ. Health Perspect., 2012, vol. 120, no. 11, pp. 1503-1511.

15. Kashcheev V.V., Chekin S.Yu., Maksioutov M.A., Tumanov K.A., Menyaylo A.N., Kochergina E.V., Kashcheeva P.V., Gorsky A.I., Shchukina N.V., Karpenko S.V., Ivanov V.K. Radiation-epidemiological study of cerebrovascular diseases in the cohort of Russian recovery operation workers of the Chernobyl accident. Health Phys., 2016, vol. 111, no. 2, pp. 192-197.

16. Kashcheev V.V., Chekin S.Yu., Karpenko S.V., Maksioutov M.A., Menyaylo A.N., Tumanov K.A., Kochergina E.V., Kashcheeva P.V., Gorsky A.I., Shchukina N.V., Lovachev S.S., Vlasov O.K., Ivanov V.K. Radiation risk of cardiovascular diseases in the cohort of Russian emergency workers of the Chernobyl accident. Health Phys., 2017, vol. 113, no. 1, pp. 23-29.

17. Ivanov V.K., Chekin S.Yu., Maksioutov M.A., Kashcheev V.V., Karpenko S.V., Tumanov K.A., Korelo A.M., Kochergina E.V., Vlasov O.K., Shchukina N.V., Lovachev S.S. Radiation risk of incidence of hypertensia among Russian recovery operation workers of the Chernobyl accident. Meditsinskaya radiologiya i radiatsion-naya bezopasnost – Medical Radiology and Radiation Safety, 2017, vol. 62, no. 1, pp. 32-37. (In Russian).

18. International Statistical Classification of Diseases and Related Health, 10th revision (ICD-10). Vol. 1 (Part 1). Geneva, WHO, 1995. 698 p. (In Russian).

19. International Statistical Classification of Diseases and Related Health, 10th revision (ICD-10). Vol. 1 (Part 2). Geneva, WHO, 1995. 633 p. (In Russian).

20. Chekin S.Yu., Maksioutov M.A., Kashcheev V.V., Karpenko S.V., Tumanov K.A., Kochergina E.V., Zelenskaya N.S., Lashkova O.E. Estimating of radiation risks of non-cancer diseases among Russian Chernobyl cleanup workers. Radiatsiya i risk – Radiation and Risk, 2021, vol. 30, no. 1, pp. 78-93. (In Russian).

21. Kashcheev V.V., Chekin S.Yu., Karpenko S.V., Maksioutov M.A., Tumanov K.A., Kochergina E.V., Glebova S.E., Ivanov S.A., Kaprin A.D. Estimating of radiation risks of malignant neoplasms among Russian Chernobyl cleanup workers. Radiatsiya i risk – Radiation and Risk, 2021, vol. 30, no. 1, pp. 58-71. (In Russian).

22. Breslow N., Day N. Statistical methods in cancer research. Vol. II. The design and analysis of cohort studies. IARC Scientific Publication No. 82. Lyon, IARC, 1987. 406 p.

23. Preston D.L., Lubin J.H., Pierce D.A. EPICURE User's Guide. Seattle, Hirosoft International Corp., 1993. 330 p.

24. Ivanov V.K., Chekin S.Yu., Maksioutov M.A., Tumanov K.A., Karpenko S.V., Pryakhin E.A., Shchukina N.V., Zelenskaya N.S., Ivanov S.A., Kaprin A.D. Assessment of radiation risks of cancer incidence and mortality among participants in the consequences of the Chernobyl accident. Radiatsiya i risk – Radiation and Risk, 2026, vol. 35, no. 2, pp. 70-91. (In Russian).

25. ICRP, 2012. ICRP statement on tissue reactions / early and late effects of radiation in normal tissues and organs – threshold doses for tissue reactions in a radiation protection context. ICRP Publication 118. Ann. ICRP, vol. 41, no. 1-2, pp. 1-326.

26. Ozasa K., Shimizu Y., Suyama A., Kasagi F., Soda M., Grant E.J., Sakata R., Sugiyama H., Kodama K. Studies of the mortality of atomic bomb survivors, Report 14, 1950-2003: an overview of cancer and noncancer diseases. Radiat. Res., 2012, vol. 177, no. 3, pp. 229-243.

27. Chekin S.Yu., Maksioutov M.A., Kashcheev V.V., Karpenko S.V., Tumanov K.A., Korelo A.M., Kocher-gina E.V., Zelenskaya N.S., Lashkova O.E., Shchukina N.V., Ivanov V.K. The influence of dose uncertainty on the assessment of radiation risks of non-cancer mortality among Russian participants in the liquidation of the consequences of the accident at the Chernobyl nuclear power plant. Radiatsiya i risk – Radiation and Risk, 2022, vol. 31, no. 2, pp. 21-35. (In Russian).

28. Chekin S.Yu., Karpenko S.V., Maksioutov M.A., Kascheeva P.V., Korelo A.M., Shchukina N.V., Kochergina E.V., Lashkova O.E., Zelenskaya N.S. Assessment of radiation risks of mortality from circulatory system diseases in the cohort of liquidators of the consequences of the accident at the Chernobyl nuclear power plant, considering the influence of other diseases identified during the observation period. Meditsinskaya radiologiya i radiatsionnaya be-zopasnost – Medical Radiology and Radiation Safety, 2024, vol. 69, no. 5, pp. 87-94. (In Russian).

29. Chekin S.Yu., Gorski A.I., Maksioutov M.A., Karpenko S.V., Tumanov K.A., Shchukina N.V., Kochergina E.V. Assessment of radiation risks of digestive system diseases among Chernobyl liquidators, considering the in-fluence of other diseases identified in them during the follow-up period. Meditsinskaya radiologiya i radiatsion-naya bezopasnost – Medical Radiology and Radiation Safety, 2025, vol. 70, no. 4, pp. 55-65. (In Russian).

30. Chekin S.Yu., Maksioutov M.A., Karpenko S.V., Gorski A.I., Tumanov K.A., Shchukina N.V., Zelenskaya N.S., Kochergina E.V. Estimation of radiation risks of respiratory diseases in liquidators of the Chernobyl nuclear power plant accident consequences taking into account the influence of other diseases detected in them during the observation period. Radiatsiya i risk – Radiation and Risk, 2025, vol. 34, no. 2, pp. 21-38. (In Russian).

31. Gorski A.I., Chekin S.Yu., Maksioutov M.A., Korelo A.M., Kochergina E.V., Zelenskaya N.S., Ivanov V.K. Study of the impact of noncancer diseases on assessments of radiation risks of the cancer incidence among the Chernobyl accident liquidators. Radiatsiya i risk – Radiation and Risk, 2024, vol. 33, no. 4, pp. 15-28. (In Russian).

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